"Dr. Fitzgerald owns certain complex financial interests that have imposed a broad recusal limiting her ability to complete all of her duties as the CDC Director," Department of Health and Human Services (HHS) spokesman Matt Lloyd said in a statement.

"Due to the nature of these financial interests, Dr. Fitzgerald could not divest from them in a definitive time period. After advising [HHS] Secretary [Alex] Azar of both the status of the financial interests and the scope of her recusal, Dr. Fitzgerald tendered, and the Secretary accepted, her resignation. The Secretary thanks Dr. Brenda Fitzgerald for her service and wishes her the best in all her endeavors."

Fitzgerald’s replacement should be someone within the agency, several infectious disease experts said. “CDC and the nation are facing an unprecedented level of threats to the nation’s health, from the current flu epidemic, the ever-present threat of emerging infection, highly antibiotic resistant bacteria, the opioid epidemic with its synergistic impact on hepatitis C and HIV, and many more,” said Andrew Pavia, chief of pediatric infectious diseases at the University of Utah, in Salt Lake City, in an email to MedPage Today.

“The next director needs to have experience at CDC and in public health, and must have vision and leadership. To quickly find someone who meets those demands and is free of financial and political conflicts of interest, the administration need look no farther than several of the current leaders within CDC, or some of the recently departed leaders.”

Carlos del Rio, MD, chair of the global health department at Emory University, in Atlanta, was even more specific. “To me, Ann Schuchat who has already been interim director, is the right person; she knows the agency and is technically strong and very much respected,” he wrote in an email. “CDC should not be a political appointment; we need someone who can look after public health for everyone.”

Del Rio said he was shocked by Fitzgerald’s resignation. “I am sorry to see Dr. Fitzgerald [go] as, from what I hear from CDC colleagues, she was doing a good job ‘managing up’ — meaning talking to funders and Congress about how critical CDC is. She clearly made a mistake of judgment and it was costly.”

"Our CDC director still has to recuse herself on some of the important health issues that we face," Sen. Patty Murray (D-Wash.), ranking member of the Senate Health, Education, Labor, & Pensions Committee, said earlier this month during a hearing on preparedness for public health emergencies. "I'm concerned she still can't give her full attention to all of the pressing health threats we face, and I hope all these conflicts will be resolved soon."

Committee member Sen. Johnny Isakson (R-Ga.) responded that, as chairman of the Senate Select Committee on Ethics, he had spoken with Fitzgerald on Wednesday "and I have gotten her in touch with the appropriate people to deal with the issue. She is forthrightly dealing with it to the best I can determine and I'm working expeditiously to see that we can get it done as quickly as possible, so she will not be in conflict to testify whatsoever. And that is her desire as well."

Fitzgerald's resignation is not the first high-profile departure this year among HHS officials; Brian Neale, the Centers for Medicare & Medicaid Services official in charge of the Medicaid program, announced last week that he will be stepping down next month.

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